A case for stocking O D+ red blood cells in emergency room trauma bays

• Published in: Transfusion (Philadelphia, Pa.) Vol. 55; no. 4; pp. 791 - 795
• Main Authors: Meyer, Erin, Uhl, Lynne
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2015; Wiley Subscription Services, Inc
• Subjects: ABO Blood-Group System - analysis; Adult; Age; Aged; Aged, 80 and over; Blood; Blood Group Incompatibility - blood; Blood Group Incompatibility - immunology; Blood Group Incompatibility - prevention & control; Blood Grouping and Crossmatching; Blood transfusions; Emergencies; Emergency medical care; Emergency Service, Hospital; Erythrocyte Transfusion - adverse effects; Female; Hemorrhage - etiology; Hemorrhage - therapy; Hospital Mortality; Humans; Isoantibodies - blood; Length of Stay - statistics & numerical data; Male; Middle Aged; Retrospective Studies; Rh-Hr Blood-Group System - analysis; Rh-Hr Blood-Group System - immunology; Trauma Centers; Wounds and Injuries - complications; Wounds and Injuries - mortality
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.12925

Background AABB Standard 5.27 requires transfusion services to have a process for urgent release of blood before completion of compatibility testing. Our institution endorses a policy for the emergency release of group O, D+ red blood cells (RBC; O+ RBC) to males and females at least 50 years of age. Our emergency department (ED) stocks 4 O− RBC units. To determine if O+ RBCs can replace ED O− RBCs, we performed a retrospective review. Study Design and Methods Patients admitted to the ED between January 2001 and August 2011 and transfused emergency‐release O− RBCs were identified. Data were collected on sex, age, length of stay, clinical status, ABO/Rh, RBC transfusions, and RBC antibody screen results. Results A total of 498 ED O− RBC units were transfused to 268 patients (168 male, 100 female). A total of 322 units were transfused to males and 114 to females at least 50 years of age. Thirty‐nine (14%) were D− with 18 receiving O+ RBCs. A total of 109 had follow‐up antibody screens; one D− patient developed alloanti‐D. Conclusions The findings support the placement of O+ RBCs in the ED. The majority of ED O− RBCs (88%) went to patients who qualified for O+ RBCs; a minority (1.5%) of patients were D− females less than 50 years of age. The rate of alloimmunization was low.